OSCE’s

That is our first scenario for discussion, you will start discussion by yourselves first because I want to
see how can you go through it by yourselves first , then once you have doubts I will help you .

1. Mrs.white is Regular patient at your clinic made emergency appointment today as she has sore
tooth, patient told that pain is excruciating, also pain on biting grainy foods, hot and cold stimuli and
she is not able to sleep either. In pervious check-up 12 months ago, you mentioned she had big
amalgam filling on 25 and 26 and there was little gap between those teeth and you recommended
redo the filling to close the gap; on 36 you recommended to do crown because there is big amalgam
filling. Gather information, explain tests to the patient and consult about possible diagnosis.

2. Mr.Burgass 35 year-old patient came to your practice on a Friday afternoon 4:00 pm. Patients
want to have strong painkiller for his toothache. He has an appointment with her dentist next week
to start RCT on the tooth. Normal painkillers are not effective, and he can’t sleep. He also has
treatment for her back pain due to her work by physiotherapist, and she has a pain relief patch for
her backache, patient gave history of taking Fentanyl, and Tramadol as well. He just wants to have
painkillers but doesn´t want to have any examination. Patient is very adamant that he only wants
painkillers and no treatment. Gather information and consult with the patient.

Q. can't you give 1-2 tablets of tramadol,please!

Q.can i go to hospital, will they give me this meds?

3. Mr.Smith 45yr old Patient has red patch on his tongue white line around the patch. He feels
burning sensation when he is eating spicy food. No sensitivity to other kinds of food. He is worried
about it because he thinks is some kind of infection, the patient has no relevant medical history,
reports no allergies. On interrogation the patient didn´t have any relevant medical history, he thinks
there is some family history (cousin brother has this)similar to what he is experiencing, he told his
brother might have the same thing, the patient told that recently he had a promotion at work and
because of that he has a lot of stress. Diagnosis and management.

Q.is this something fungal or cancerous?

4. Mrs.___Patient have severe pain and swelling on gum between 11,21 on radiography there is no
radiolucency and pulp vitality test shows tooth vital there is pocket around 6 mm on mesial of 11
and there is general measurements 4-5 mm. On interrogation the patient said that the last dental
visit was 4 or 5 years ago and nothing in particular was mentioned back then, just scale and clean
were done, during this appointment you did a full periodontal chart, sensibility test done - tooth is
vital, pic 11, 21+ pa 11, 21 + BW right and left) No medical conditions, healthy patient. Patient
smokes since he was a teenager, 5 to 7 cigarettes per day, according to the patient he brushes twice
a day and flosses regularly and he can no recall any history of early tooth loss in the family.
Diagnosed the patient and explain management.

Q.will you give anyibiotics?

5. Julie,female patient is 12 years old had trauma during hockey without wearing mouthguard. 30
minutes ago, and photo provided 21 is broken fracture to enamel dentin area no expose to the pulp
and luxated 11 didn't respond to vitality test, 21 had responded that last few seconds She didn't loss
consciousness and no vomiting no head trauma. Explain short- and long-term management to the
patient.

6. You have done an extraction of 16 in your patient, during removal a piece of the mesio buccal root
was fractured, but you were able to retrieve it by using some roots elevators, you noticed 1-2 mm
hole and air bubble. The patient doesn´t have any medical history, he is a smoker, and have some
history of hay fever in the past. Informed the patient of what has happened and explain the
management and precautions.

Q.will you give me antibiotics?